The Room Next Door

I saw a rather brilliant film last weekend. It’s called The Room Next Door and starred two outstanding actresses: Julianne Moore as Martha and Tilda Swinton as Ingrid. It was written and directed by Pedro Almodovar and was, in effect, a long conversation between two highly educated, articulate and intelligent women, one of whom, Ingrid, is terminally ill with cervical cancer. 

The film sensitively and convincingly explores what happens when Ingrid asks her old friend Martha to accompany her when she goes to a rental property where she will soon decide the point at which she wants to end her life, not in front of Martha, but in the room next door.

The film resonated very strongly with me because earlier this year I had two weeks of living with the possibility that I might have late-stage ovarian cancer. I had all the symptoms of what is often called ‘the silent killer’ because it tends to manifest too late for curative treatment. Some of you may find my thought processes and attitude to this potential diagnosis baffling and even enraging, but I can only tell you, honestly, what I was determined to do if I received the worst possible news that I was terminally ill. And that was to adamantly refuse to spend my final months in hospital having any kind of intrusive and painful therapeutic medical treatment. I even googled “can you refuse medical treatment?” and was reassured that you could.

In the event, thorough scans and blood tests indicated some issues with liver function (still under investigation) but no sign of ovarian or any other cancer. Cue massive relief all round, but the experience has left me with an even stronger belief that there should be a change in the law in the UK to allow assisted suicide, because currently anyone who helps a terminally ill person to die faces the possibility of a prison sentence of 14 years. Something that Martha in the film is confronted with when she is grilled at length by a religious and very self righteous police officer immediately after Ingrid takes the euthanasia pill which she obtained on the dark web.

This wonderfully sensitive film is very timely for us here in the UK. A new bill to allow assisted dying was debated for the first time on 16th October 2024 thanks to a Private Members’ Bill which is being championed by Kim Leadbetter, sister of Jo Cox, the Batley and Spen MP who was murdered in her constituency in 2016. The bill will be debated for the second time on 29th November. However, despite the fact that the largest and most in-depth opinion polling ever conducted showed earlier this year that public support for assisted dying is at a record high of 75%, the bill will meet fierce opposition from groups hoping that MPs will repeat what happened in 2015, when, by majority of 330 to 118, they voted against any change in the law.

I have already made clear what my position is on this delicate and challenging issue, but I am also interested to understand what the objections are too, so, here is the case for a change in the law and also the arguments for why many people believe such a change is deeply undesirable.

The Case For Why Assisted Dying Should Be Made Legal

Because 200m people worldwide have legal access to some form of assisted dying, which means that there is a wealth of evidence to support both the principle and the practice of how best to help people who want to end their own lives. A House of Commons Inquiry confirmed in February 2024 that laws which allow it are working well around the world with most having robust safeguards, a positive impact on palliative care and no evidence of ‘a slippery slope’ towards unfettered and widespread euthanasia.

Because currently, terminally ill people who strongly desire to shorten their pain and suffering are terrified that after they commit suicide, their nearest and dearest might be prosecuted and imprisoned for helping them. In the film Ingrid goes to great lengths to protect Martha by leaving letters for the police explaining how she has taken her own life. She insists that Martha is in ‘the room next door’ and that she will signal that she has carried out her intention by closing her bedroom door which will otherwise be left open. Even these precautions look precarious once the zealous police officer gets involved.

Because at the moment one British person travels to Dignitas in Switzerland every eight days in order to end their life. However this route is only available to you if you can afford the (on average) cost of £10,000 and if you are both well enough to travel that far and still able to self administer the fatal dose. It’s likely that those suffering progressive diseases choose to go much sooner than they need to so that they still have the necessary mental and physical capacity to be accepted under the Swiss law.

Because it is often said that we treat our animals much more humanely than we do those people who wish to have some choice and control over the circumstances of their death. I spent the last three weeks of my mother’s life with her in much the same way that Martha accompanies Ingrid on her final journey. In the film Ingrid becomes happier, calmer and resigned once she settles into the beautiful rented house. That was the experience I had with my mother who was in a lovely room in a small nursing home overlooking a garden filled with spring flowers. Every day she would say “I hope it’s soon now, I’m so tired.” At the time we had no idea how long it would take for her to succumb to her terminal cancer, but, with a change in the law, she would have been granted her final wish to end her suffering at a time of her choosing.

The Case Against the Legalisation of Assisted Dying

The strongest argument is that societies should be focussed on well-funded, accessible, high-quality palliative care for all, rather than on condoning the taking of lives. Gillian Wright, a former palliative care registrar puts the case that “the primary danger of assisted suicide is that individual lives are devalued by society because they are ill, disabled, confused and that their contribution to society is perceived to be minimal.”

There are two powerful lobbies against assisted dying in this country who unite under the banner of ‘Kill the Bill, Not the Ill’. Both groups have strong and powerful representation in the House of Lords which, as the second chamber, can amend any legislation proposed by the House of Commons. The first is the religious lobby, with the Archbishop of Canterbury, a member of the House of Lords, stating his outright opposition to the proposed new bill. Interestingly, in the general population, polling suggests that there is strong support for the bill even amongst those who follow a religion with 69% of Christians and 65% of Catholics in favour of assisted dying. The second is the disabled lobby and paralympian Dame Tanni Grey-Thompson, who also sits in the House of Lords, has stated her opposition thus: “This bill increases the pressure on the old and disabled to stop being a burden and the right to die then becomes a duty to die.”

Kim Leadbetter’s Bill is seeking "to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life”. The right to do this will be restricted to those who are deemed to be mentally competent and who have only six months or less to live (although this may be extended to twelve months). 

Safeguards are likely to include the need for two doctors to assess that the person is making an informed decision without pressure or coercion. The doctors would also ensure that the person has been fully informed of palliative, hospice and other care and has signed a written declaration of their request which is witnessed and signed by both doctors. These are all standard practices in those countries which allow assisted dying by law.

Last week there were some comments about this weekly blog being so uplifting, so I feel I should apologise to those of you who have found this discussion rather depressing. I certainly didn’t mean to lower your mood this Sunday morning, but I am very interested to hear your thoughts on this important subject as it is being debated in parliament.

I feel quite passionately that I’ve had (and am still having) a really good life and, if faced with Ingrid’s situation and when my time comes, I’d also like to have the choice of a good death if I could be afforded that opportunity under the law.

Tricia x

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